The Effects Of Alcohol In Hepatitis B Virus-related Hepatocellular Carcinoma

Background:Hepatocellular carcinoma (HCC) is one of the most common cancers in the worldwide. The incidence and mortality associated with HCC are increasing. In China, the hepatitis B virus (HBV) infection is the most important cause of HCC, and alcohol is also an important risk factor for HCC. To evaluate the effects of alcohol in the HBV-related HCC, the data of the surgical patients were retrospectively analyzed.Methods:There were 164 patients with the background of hepatitis B (HBsAg+) undergoing local or liver segment resection(one or two of the largest diameter and< 5cm) between March 2010 to March 2011 in our hospital. Depending on whether long-term drinking (drinking time>5 years, equivalent to the amount of alcohol men >40g/d, women>20g/d) and preoperative HBV-DNA>104 copies/ml or≤104 copies/ml, the total cases are divided into four groups:drinking with high HBV load (A+H+ group), drinking with low HBV load (A+H-group), non-drinking with high HBV load (A-H+group), non-drinking with low HBV load (A-H-group), compared clinical data between the four groups. Results:The whole group of 164 HCC patients, there were 29 patients (17.7%) in the A+H+group, the drinking time was 23.4±9.2 years, alcohol consumption was 199.3±145.3g/d; and there were 25 patients (15.2%) in the A+H-group, drinking time was 23.3±9.6 years, alcohol consumption was 113.3±80.lg/d; A-H+group had 36 patients (22.0%) and no history of drinking; A-H-group had 74 patients (45.1%) and no drinking history. Each group no significant difference between the age of onset. Compared with the A+H-group, the preoperative serum Alb of A+H+group was significantly lower(41.9±5.0 g/L vs.44.5±5.1 g/L,P=0.03), preoperative serum ALT was significantly higher(51.5±25.0 U/L vs.32.0±13.2 U/L,P=0.013), preoperative serum AST was significantly higher(42.9±14.1 U/L vs.30.7±14.9 U/L.P=0.015); one day postoperative serum Alb was significantly slower recovery (32.9±5.0 g/L vs. 35.4±5.6 g/L.P=0.04), seven days postoperative serum Alb was significantly slower recovery(34.7±4.1 g/L vs.38.2±4.2 g/L,P=0.007), tumor diameter was significantly larger (3.4±1.0cm vs.2.5±.1cm, P=0.003). Compared with the A-H-group, the preoperative serum Alb of A+H+group was significantly lower(41.9±5.0 g/L vs. 44.3±3.9 g/L,P=0.013), preoperative serum ALT was significantly higher(51.5±25.0 U/L vs.32.5±29.9 U/L.P=0.002), preoperative serum AST was significantly higher(42.9±14.1 U/L vs.30.7±17.4 U/L,P=0.002); one day postoperative serum Alb was significantly slower recovery (32.9±5.0 g/L vs.36.0±5.5 g/L.P=0.01), seven days postoperative serum Alb was significantly slower recovery(34.7±4.1 g/L vs.37.7±4.5 g/L,P=0.003). There was no significant difference among other groups about ALT, AST. TB, Che, ICG15m, AFP, etc. Tumor size, number and differentiation are also no significant differences. Conclusion:1. Chronic alcohol consumption and high load of HBV have a synergistic effect in the liver function. In the background of chronic alcohol consumption, the high load of HBV decreases preoperative liver synthetic function and delays the postoperative recovery of hepatic synthetic function, and damaged the metabolism of liver enzymes.2. In the background of chronic alcohol consumption, the high load of HBV makes the larger diameter of HCC.